<div id="header-sign-up">
    <?php include_partial("progress_bar") ?>
    <form id="step-one-form" action="<?php echo url_for('/doctor-register-step-one') ?>" method="post">
        <?php echo $form->renderHiddenFields(false) ?>
        <div class="imperative">Let's get into business cooperatively! Please specify your details below.</div>
        <?php include_partial("common/input_field", array("form" => $form, "field" => "first_name")) ?>
        <?php include_partial("common/input_field", array("form" => $form, "field" => "last_name")) ?>
        <?php include_partial("common/select_field", array("form" => $form, "field" => "language_id")) ?>
        <?php include_partial("common/select_field", array("form" => $form, "field" => "gender")) ?>
        <div class="imperative">Kindly specify login credentials to secure your account below.</div>
        <?php include_partial("common/input_field", array("form" => $form, "field" => "email")) ?>
        <?php include_partial("common/input_field", array("form" => $form, "field" => "password")) ?>
        <?php include_partial("common/input_field", array("form" => $form, "field" => "password_confirm")) ?>
        <?php include_partial("common/select_field", array("form" => $form, "field" => "speciality_id")) ?>
        <?php include_partial("common/input_field", array("form" => $form, "field" => "terms")) ?>
        <div class="row">
            <ul>
                <li>
                    <button id="submit-step-one" type="submit" class="blue-button-30">Proceed</button>
                </li>
            </ul>
        </div>
        <div class="clear"></div>
    </form>
</div>